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HomeMy WebLinkAboutApplication FOR OFFICE SE LY CASE N l 5 - t (1:irff" Lo DATE SUBMITTED: ( a- TIME: l 1 CITY OF COL 1,1::GE STATION Home of Texas AerM University' STAFF: PRIVATE IMPROVEMENT IN PUBLIC ROW PERMIT (PIP) APPLICATION MINIMUM SUBMITTAL REQUIREMENTS: J x $350 PIP Application Fee. Application completed in full. This application form provided by the City of College Station must be used and may not be adjusted or altered. Please attach pages if additional information is provided. AM Notarized indemnity agreements from abutting property owners. \ Al Attach four (4) copies of a facility layout plan, which shall include the following: © Location, identification, and dimensions of ROW and pavement edge /curb. p Location of all proposed improvements. Location of all public utilities (existing) - dimensioned from right -of -way or back of curb, material, size. A signage plan - include dimensions of sign(s), location from back of curb, materials, elevation drawing (if applicable). 1.(/] Drainage and /or erosion control plan (if applicable). 1JN Proposed waterway alterations with supporting drainage report (if applicable). NftE Landscape plan showing the location and type of plantings - existing and proposed, both common names and scientific (if applicable). IJM The cost estimate for relocating any public facilities associated with the work (if applicable). W I C An electrical plan (if applicable). p ] Sealed irrigation / plumbing plan (if applicable). IJX Sealed structural plan showing details with anchoring, attachment, and material description (if applicable). p/] Private utility plan- dimensioned from right -of -way or back of curb, material, size (if applicable). LOCATION OF IMPROVEMENTS: Dalton Lane and Greens Prairie Road ROW along Lots 1 -7, Block 11, and Lots 11 -17, Block 1, Castlegate 11 Subdivision, Section 202. APPLICANT /PROJECT MANAGER'S INFORMATION (Primary contact for the project): Name Wallace Phillips IV E -mail dustyphillips52 @yahoo.com Street Address 4490 Castlegate Drive City College Station State Texas Zip Code 77845 Phone Number 979.690.7250 Fax Number 979.690.1041 PARTY RESPONSIBLE FOR MAINTENANCE (If party is a group, please provide information for contact person): Name 3 -D Development, LLC E -mail dustyphillips52 @yahoo.com Street Address 4490 Castlegate Drive City College Station State Texas Zip Code 77845 Phone Number 979.690.7250 Fax Number 979.690.1041 10/10 Page 1 of 4 IDENTIFY THE FOLLOWING: The total valuation of the work: $ 2I , Z °o The total valuation of the signage: $ C,Soz> Estimated cost of future relocation /remodel of improvements: $ The total footage of the site: 200 The total linear feet of water lines crossing under paved road: IDENTIFY THE TYPE OF WORK TO BE PERFORMED: ❑ Awnings Structural Contractor: ❑ Benches Number of Benches: ❑ Bike racks Number of Bike Racks: ❑ Cafe *Structural Contractor: ❑ Canopy *Structural Contractor: ❑ Demolition Structural Contractor: ❑ Electrical Master Electrician: ❑ Facade Structural Contractor: ❑ Irrigation System State Licensed Irrigator: ❑ Landscaping *Landscape Architect/Company: El Masonry fence *Structural Contractor: 3 -D DEVELOPMENT, LLC p Sign(s) *Sign Contractor: 3 -D DEVELOPMENT, LLC ❑ Waterway Alterations Design Engineer: El Wood fence *Structural Contractor: 3 -D DEVELOPMENT,LLC ❑ Other (please describe) Identify party to perform this work: *The starred items may not require that structural contractors, sign contractors, or landscapers perform the work - contact applicable City Departments for determination I hereby verify that the information contained in this application is true and complete, to the best of my knowledge. I understand that the City has the authority to inspect the work to be conducted within the public right -of -way at any time. 1 also understand that this permit may be revoked at any time at the discretion of the City Officials. / 1 114- `8- - Signature and title Date Conditions of Approval: Authorization of City Engineer Date approved 10/10 Page 2 of 4 INDEMNIFICATION Date: Indemnitor: 3 -D Development, LLC Indemnitor's Address: 4490 Castlegate Drive (including county) College Station, Texas 77845 Brazos County Indemnitee: CITY OF COLLEGE STATION indemnitee's Address: 1101 Texas Avenue (including county) Brazos County College Station, Texas 77840 LEGAL DESCRIPTION OF PROPERTY: DALTON LANE RIGHT OF WAY PER CASTLEGATE 11 SECTION 202 PLAT To the fullest extent permitted by law, I /we the owners of the property described above (Indemnitor), shall indemnify, hold harmless, and defend the lndemnitee, its officers, agents, and employees from and against any and all claims, losses, damages, causes of action, suits and liability of every kind, including all expenses of litigation, court costs, and attorney's fees, for injury to, or death of, any person, for damage to any property, or for any breach of contract, arising out of or in connection with the installation, operation, and maintenance of the facilities authorized by the Private Improvement Permit issued by Indemnitee to the City of College Station , including, but not limited to, any premise defect or special defect arising out of or in connection with said facilities. This Indemnification shall apply regardless of whether such injuries, death, damages, or breach are caused by the NEGLIGENCE or omission of Indemnitee, the contractor installing said facilities, or any third party. All provisions of this Indemnification shall be binding upon and inure to the benefit of the undersigned and the City of College Station, Texas, and their respective successors and assigns. te Wu. 1 (G CE s t, Property Owner Printed Name STATE OF TEXAS § § ACKNOWLEDGEMENT COUTY OF BRAZOS § TW ed13 Subscribed and sworn to before me, a Notary Public, this day of AOC 05T , -2669 by 41c., ii-$1iZ L' �C.vl. es s r RICHARD C. FLORES Notary blic in and for + °'� Notary Public, State of Texas s y= My Commission Expires the State of Texas ;,off ;;:. March 29, 2016 10/10 • Page 3 of 4 Property Owner Printed Name STATE OF TEXAS § § ACKNOWLEDGEMENT COUTY OF BRAZOS § Subscribed and sworn to before me, a Notary Public, this day of , 2009 by Notary Public in and for the State of Texas 10/10 tCrit Page 4 of 4 • • co y W O3 ,ry F J • tij. ✓ ✓.r,. e--4 Ce p w a M a • ▪ ` ` o" ,,. N. W Q ti 1 . r Y U d Vl w a y .�. ,;',, ,, V " 0 AI q e `` . A ` '. --`' ' o 1 w al fi x , , Q W °- 1 i `` , `' ▪ ,, 3°o / I ) o w ``: ‘", r 2° C Q (� K¢ a F W ▪ \�'`�.``.. ` \J a a3 k • �; M f z .a . / ts E 3 0 � w I k ° ` N " ~ XQ I I F . W co N wQ w y J A �. - -- c !! _ b,� I W a I ce • I D�llts�n Lane �.. I 1 Q CZ rgl Cs1 CL 27' B —B ASPH PVMT, 5' ROW I I N ;, • Z W w • o£ �V — �.or a ! W o s 3 3 �MI I y �; �7 y w w Z .,,_,co. {a k ez w^ J 3 Q Na I •( W V O Gi m M ,—r 3 a y in o . 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